Obesity OR Research Articles

Short-chain fatty acids and insulin sensitivity: a systematic review and meta-analysis.

There is substantial evidence that reduced short-chain fatty acids (SCFAs) in the gut are associated with obesity and type 2 diabetes, although findings from clinical interventions that can increase SCFAs are inconsistent. This systematic review and meta-analysis aimed to assess the effect of SCFA interventions on fasting glucose, fasting insulin, and homeostatic model assessment of insulin resistance (HOMA-IR). Relevant articles published up to July 28, 2022, were extracted from PubMed and Embase using the MeSH (Medical Subject Headings) terms of the defined keywords [(short-chain fatty acids) AND (obesity OR diabetes OR insulin sensitivity)] and their synonyms. Data analyses were performed independently by two researchers who used the Cochrane meta-analysis checklist and the PRISMA guidelines. Clinical studies and trials that measured SCFAs and reported glucose homeostasis parameters were included in the analysis. Standardized mean differences (SMDs) with 95%CIs were calculated using a random-effects model in the data extraction tool Review Manager version 5.4 (RevMan 5.4). The risk-of-bias assessment was performed following the Cochrane checklist for randomized and crossover studies. In total, 6040 nonduplicate studies were identified, 23 of which met the defined criteria, reported fasting insulin, fasting glucose, or HOMA-IR values, and reported change in SCFA concentrations post intervention. Meta-analyses of these studies indicated that fasting insulin concentrations were significantly reduced (overall effect: SMD = -0.15; 95%CI = -0.29 to -0.01, P = 0.04) in treatment groups, relative to placebo groups, at the end of the intervention. Studies with a confirmed increase in SCFAs at the end of intervention also had a significant effect on lowering fasting insulin (P = 0.008). Elevated levels of SCFAs, compared with baseline levels, were associated with beneficial effects on HOMA-IR (P < 0.00001). There was no significant change in fasting glucose concentrations. Increased postintervention levels of SCFAs are associated with lower fasting insulin concentrations, offering a beneficial effect on insulin sensitivity. PROSPERO registration number CRD42021257248.

Long-Term Outcomes of Bariatric Surgery: A Systematic Review.

Roux-en-Y gastric bypass (RYGB) is a minimally invasive procedure that usually takes two hours. It is commonly performed in refractory cases to help morbidly obese patients (BMI ≥ 40 kg/m2) lose weight. It is well known that morbid obesity accompanies other comorbid conditions such as atherosclerotic diseases, strokes, cancers, and mental health issues such as anxiety and depression. It is crucial to treat this category of patients to improve their quality of life and minimize the chance of mortality in these patients. Given the importance of treating this group, we explored the long-term outcomes of patients who underwent bariatric surgery for cardiovascular diseases, cancer, and depression compared to those who did not. This systematic review utilized articles identified through PubMed using the following search terms: (morbidly obese OR obesity OR obese) AND (bariatric surgery OR metabolic surgery OR gastric bypass OR gastrectomy)AND (chronic disease OR chronic diseases OR cardiovascular diseases OR heart diseases OR cancer OR neoplasms OR stroke OR depressive disorder OR depression). The filter used was observational studies, which yielded 217 studies. Out of these results, eight citations were included in an observational study that met our eligibility criteria. From our search, the articles showed a clinically significant decrease in the incidence of cardiovascular disease, cancer, and depressive disorders after treatment with bariatric surgery. Furthermore, there was also a correlation between bariatric surgery and remission of type 2 diabetes. The surgery has an apparent protective effect on the development and progression of comorbid conditions accompanying morbid obesity. Overall, the quality of life has improved in patients who have undergone the procedure compared to those who have not. Bariatric surgery must be recommended as a beneficial option in managing morbidly obese patients (BMI ≥ 40 kg/m2) who have responded poorly to first-line management plans.

Association of Macronutrients Intake with Body Composition and Sarcopenic Obesity in Children and Adolescents: A Population-Based Analysis of the National Health and Nutrition Examination Survey (NHANES) 2011-2018.

The association of macronutrients intake with body composition and sarcopenic obesity remains uncertain in children and adolescents. We aimed to explore the association between macronutrients intake and body composition, especially sarcopenic obesity, in children and adolescents residing in the United States. The study utilized data from 5412 participants aged 6-17 years who attended NHANES between 2011 and 2018. Body composition was assessed using DXA, and nutrient intake was based on 24-h recall. Multivariable linear regression and multinomial logistic regression were used. The unweighted prevalence of sarcopenic obesity was 15.6%. A higher percentage of energy (5 %E) from fat was inversely associated with muscle mass but positively associated with fat mass and sarcopenic obesity. Substituting carbohydrate (5 %E) with fat decreased muscle mass by 0.03 (95% CI 0.01 to 0.06) but increased fat mass by 0.03 (95% CI 0.01 to 0.06) and increased the prevalence of sarcopenic obesity by 254% (95% CI 15% to 487%). Replacing protein intake with fat intake also increased the OR of sarcopenic obesity (OR, 2.36 [95% CI 1.18 to 3.18]). In conclusion, a high-fat diet, coupled with low carbohydrate/protein intake, is associated with sarcopenic obesity among children and adolescents. The change in children's diet towards a healthy diet with low fat composition may help prevent sarcopenic obesity. However, randomized clinical trials or longitudinal studies are needed to further validate our findings.

72 A survey of North American horse diets: What are we missing?

Balanced nutrition is critical for the health and well-being of horses. To date, there is limited information on the composition of North American equine diets. Here, we describe an analysis of 200 equine diets and how they compare with NRC requirements. Owners from the US and Canada submitted their diets for review by a nutritionist. They were asked to provide information on their horses’ age, weight, exercise level, diet composition, and health concerns. They were also asked to classify their horses' body condition as underweight (UW), slightly underweight (SU), normal weight (NW), slightly overweight (SO), overweight (OW), or obese (OB). Our sample population includes mature horses of various breeds and exercise levels. Diet nutrient composition was based on guaranteed analyses provided by manufacturers and an average hay analysis corrected for variations in regional soil mineral contents, or the hay analysis submitted by the horse owner where available. Nutrient intakes were compared with each horse's requirements based on their exercise level and body weight, obtained from the NRC, to calculate nutrient intake as a percentage of requirements. Wilcoxon Signed Rank Tests and descriptive statistics were used to analyze the data in Prism. Data are presented asmean intakes as a percentage of requirements ± SEM. Our results revealed that diets were providing an adequate amount of selenium (113 ± 8%) and vitamin E (106 ± 7%). Diets were slightly over-supplying energy (118 ± 1%; P < 0.0001), zinc (125 ± 5%; P = 0.0002), copper (151 ± 6%; P < 0.0001), manganese (132 ± 5%; P < 0.0001), and vitamin A (138 ± 8%; P = 0.001). Protein (191 ± 3%), lysine (203 ± 4%), iron (352 ± 6%), phosphorus (192 ± 4%), calcium (292 ± 7%), magnesium (264 ± 4%), and potassium (680 ± 9%) were appreciably over-supplied (P < 0.0001), and sodium was under-supplied (65 ± 5%; P < 0.0001). Interestingly, all horses except those classified as obese were over-consuming energy (P < 0.004), with average intakes for UW horses being the highest (145 ± 8%), followed by SU (127 ± 5%), OW (122 ± 4%), SO (118 ± 3%), and NW horses (116 ± 2%). Understanding the degree to which horses are meeting or exceeding their nutritional requirements is fundamental for formulating recommendations to support performance, longevity, and overall health. This may inform future avenues of research and outreach to improve the health and well-being of the North American equine population.

Effects of Physical Activity, Fruit and Vegetables Intake, and Alcohol Consumption on Overweight or Obesity: Meta-Analysis

Background: Overweight or obesity is a public health problem worldwide which is increasing both in the general population and in people with chronic diseases. Overall both children and adults are vulnerable to overweight or obesity. This study aims to examine the effect of physical activity, consumption of vegetables and alcohol on overweight or obesity using a meta-analysis.Subjects and Method: Meta-analysis was carried out using the PRISMA flowchart and the PICO model. Population: age 6 to 64 years. Intervention: low physical activity, low vegetable and fruit consumption, and high alcohol. Comparison: high physical activity, high vegetable and fruit consumption, and alcohol low. Outcome: overweight or obese. The databases used are Google Scholar, PubMed, and Proquest with keywords (Overweight OR Obesity OR "BMI Status") AND (“Physical Activity” OR Exercise OR Sport OR Inactive) AND (Vegetable AND Fruit) AND Alcohol AND "Cross Sectional" AND aOR. There were 22 cross-sectional studies published in 2012-2022 that met the inclusion criteria. Analysis was performed with RevMan 5.3.Results: A meta-analysis was conducted on 22 articles with a cross-sectional study design originating from Indonesia, Ghana, Arab Emirates, Texas, Ethiopia, Uganda, Botswana, Congo, Bahir Dar, North Western, Toronto, Zambia, Cameroon and Tanzania involving 91,031 ages 6-64 years. The results of the meta-analysis showed that someone with low physical activity had a risk of being overweight or obese 1.35 times compared to high physical activity (aOR= 1.35; 95% CI= 1.09 to 1.68; p&lt;0.001), someone with high consumption of vegetables and fruit have a risk of experiencing overweight or obesity 1.40 times compared to high consumption of vegetables and fruits (aOR= 1.40; 95%CI= 0.94 to 2.08; p&lt;0.001), and someone with high alcohol has a risk of experiencing overweight or obesity 1.47 times compared low alcohol (aOR= 1.47; 95% CI= 1.31 to 1.65; p&lt;0.001).Conclusion: Low vegetable and fruit consumption, high alcohol consumption and low physical activity can increase the risk of being overweight or obese. Keywords: social support, self-efficacy, social cognitive theory, hypertension, medication adherence Correspondence: Dena Tri Solehaini. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: dena35tri@gmail.com. Mobile: +6282329210977.

Incidence of Arterial Hypertension is Associated with Adiposity in Children and Adolescents.

The increase of hypertension in children and adolescents has attracted the attention of the scientific community largely due to its association with the obesity epidemic. To describe the incidence of hypertension and its relationship with the cardiometabolic and genetic profile in children and adolescents from a city in southern Brazil in a three-year period. This longitudinal study followed 469 children and adolescents, aged 7-17 years old (43.1% boys), assessed at two-time points. We evaluated systolic and diastolic blood pressures (SBP and DBP), waist circumference (WC), body mass index (BMI), body fat percentage (%BF), lipid profile, glucose, cardiorespiratory fitness (CRF), and rs9939609 Polymorphism ( FTO ). Cumulative incidence of hypertension was calculated, and multinomial logistic regression was conducted. The statistical significance was established as p < 0.05. After three years, the incidence of hypertension was 11.5%. Overweight or obese individuals were more likely to become borderline hypertensive (overweight OR: 3.22, 95% CI: 1.08-9.55; obesity OR: 4.05, 95% CI: 1.68-9.75), and obese individuals were more likely to become hypertensive (obesity OR: 4.84, 95% CI: 1.57-14.95). High-risk WC and %BF values were associated with hypertension development (OR: 3.41, 95% CI: 1.26-9.19; OR: 2.49, 95% CI: 1.08-5.75, respectively). We found a higher incidence of hypertension in children and adolescents as compared with previous studies. Individuals with higher values of BMI, WC and %BF at baseline were more likely to develop hypertension, suggesting the importance of adiposity in the development of hypertension even in such a young population.

Artificial Light-at-Night Exposure and Overweight and Obesity across GDP Levels among Chinese Children and Adolescents

Evidence in adults suggests that exposure to artificial light-at-night (ALAN) leads to obesity. However, little is known about whether this effect exists in children and adolescents. We aimed to investigate whether ALAN exposure was associated with overweight and obesity in school-aged children and adolescents and whether this association varied with socioeconomic status. Data on the height and weight of 129,500 children and adolescents aged 10-18 years from 72 cities were extracted from the 2014 Chinese National Survey on Students' Constitution and Health (CNSSCH). The ALAN area percentage and average ALAN intensity were calculated using the Visible/Infrared Imager/Radiometer Suite. The subjects were separated into three categories based on the cities' gross domestic product per capita (GDPPC). A mixed-effect logistic regression model and generalized additive model (GAM) were utilized to evaluate the association between ALAN exposure and overweight and obesity in children and adolescents stratified by municipal GDPPC. Both ALAN area (OR = 1.194, 95% CI: 1.175-1.212) and ALAN intensity (OR = 1.019, 95% CI: 1.017-1.020) were positively associated with overweight and obesity in children and adolescents, and the associations remained robust after adjusting for covariates. ORs for overweight and obesity and ALAN area decreased as GDPPC level increased (first tertile: OR = 1.457, 95% CI: 1.335-1.590; second tertile: OR = 1.350, 95% CI: 1.245-1.464; third tertile: OR = 1.100, 95% CI: 1.081-1.119). Similar results were observed for ALAN intensity. In the GAM models, thresholds existed in almost all these spline trends, indicating that ALAN might have a nonlinear association with overweight and obesity. ALAN contributed to the development of overweight and obesity in children and adolescents and this effect differed with GDPPC. Future longitudinal studies should confirm the causal relationship between ALAN and obesity. Moreover, reducing unnecessary exposure to artificial light at night may have beneficial implications for controlling childhood and adolescent obesity, particularly in low-income areas.

The Association of Maternal BMI with Overweight among Children Aged 0-59 Months in Kenya: A Nationwide Cross-Sectional Study.

Childhood overweight is a growing global public health challenge and is prevalent in many countries. We aimed at exploring the prevalence of childhood overweight and the association of maternal body mass index (BMI), maternal demographic factors, and child-related factors with childhood overweight among Kenyan children aged 0-59 months. This study utilized Kenya's 2014 demographic and health survey, which was based on national representative cross-sectional data. A total of 8316 children and their mothers' data were analyzed. Overweight in children and maternal BMI were defined using WHO standard criteria. Multivariate logistics regression models were used to study the association of maternal BMI and childhood overweight. Nationally 5% of Kenyan children aged 0-59 months are overweight (5.5% male vs. 3.8% female). The highest prevalence in overweight among children was found in Central region (6.9%) and lowest in North Eastern (3.1%) which could be explained by the various economic disparities. Maternal BMI with underweight was associated with lower odds (OR 0.30, 95% CI 0.14-0.64) whereas, overweight and obesity were associated with higher odds of overweight (OR for overweight 1.64, 95% CI 1.28-2.11 and OR for obesity 1.74, 95% CI 1.22-2.47) among their children compared to normal weight mothers. Overweight among children is of great concern and therefore initiatives to tackle both child and maternal health are urgently needed.

The association analysis between exposure to volatile organic chemicals and obesity in the general USA population: A cross-sectional study from NHANES program

BackgroundIncreasing evidence have been provided that the exposure to environment pollutants was associated obesity, while whether the exposure to volatile organic chemicals (VOC) was associated with obesity or abdominal obesity is yet to be clarified. MethodA cross-sectional study using data from the 6 survey cycles (2005–2006, 2011–2018, 2017–2020) of NHANES program was performed. Obesity and abdominal obesity were identified as a BMI >30 and a waist circumference >102 cm for men or >88 cm for women respectively. The quantile logistic regression method was used to analyze the association between VOC metabolites (VOCs) in urine and obesity, and the quantile regression method was used for the association analysis between VOCs in urine and BMI, as well as waist circumference. ResultsA total of 17 524 participants (4965 obesity, 7317 abdominal obesity) were included, and participants in the obesity or abdominal obesity groups showed higher VOCs in urine than that in the control group. The CEMA was identified as the risk factor for obesity and abdominal obesity in all the 4 models, and its detected OR for obesity in the Q2 to Q4 of model 3 was 1.169 (Q2, p < 0.05), 1.306 (Q3, p < 0.001) and 1.217 (Q4, p < 0.01) respectively. And its OR for abdominal obesity in the Q2 to Q4 of model 3 was 1.222 (Q2, p < 0.01), 1.448 (Q3, p < 0.001) and 1.208 (Q4, p < 0.05) respectively. A significantly positive association between CEMA and BMI, as well as waist circumference, was also detected. ConclusionIn this study, we found that the exposure to VOC (Acrolein, Acrylamide, Acrylonitrile, 1,3-Butadiene, Crotonaldehyde, Cyanide, N,N-Dimethylformamide, Ethylbenzene, styrene, Propylene oxide, Toluene and Xylene) was significantly associated with obesity or abdominal obesity. And also, more prospective studies and related experimental researches should be carried out to further demonstrate the conclusion of this study.

Metabolic syndrome components determine the presence of subclinical atherosclerosis in obese and overweight.

Metabolic syndrome (MS) is frequently associated with an increased body mass index (BMI), and related to an adverse cardiovascular prognosis. The purpose of this study is to evaluate the prevalence and association between MS, obesity and subclinical atherosclerosis (SA). This cross-sectional study included healthy adults, allocated to normal weight (NW) when BMI <25 kg/m2, overweight (OW) BMI ≥25 and <30 kg/m2, or obese (OB) BMI ≥30 kg/m2 groups. Presence of MS was defined according to National Cholesterol Education Program (NCEP) criteria. SA was evidenced with vascular ultrasound. Association between SA, obesity and MS, was evaluated by logistic regression models. There were 3,716 patients studied (female 66.7%, mean age 47 ± 17.5 years). According to BMI, NW represented 28.2%, OW 39.4% and OB 32.4%. MS showed a strong correspondence with BMI (NW 4.9%, OW 21.4%, OB 49.7%; p<0.001). SA was more prevalent in each group when MS was present: NW (25.4% vs. 45.1%, p<0.005), OW (43.2% vs. 58.9%, p<0.0001) and OB (44.2% vs. 57.8%, p<0.0001). Logistic-regression models showed an independent association of SA with MS criteria (arterial hypertension p<0.001; high-density lipoprotein [HDL] p<0.05; and triglycerides p<0.005) adjusted by gender, age and BMI. In conclusion, overweight and obesity are frequent and strongly linked with MS and SA. Prevalence of SA is high, and is independently associated with MS components. However, BMI could not retain statistical significance in the multivariate analyses.

Effect of Maternal Obesity on Fetal Macrosomia: Meta-Analysis

Background: Obesity is a condition that shows an imbalance between height and weight. Obesity in women poses a risk to future pregnancies and their pregnancy outcomes. One of the risks of preg¬nancy in obese women is the birth of babies with excess weight or macrosomia. Excess birth weight can increase the risk of death for both mother and baby. This study aims to examine the effect of obesity in pregnant women on child birth using macrosomia. Subjects and Method: Meta-analysis was performed with the PRISMA flowchart using PubMed, Science Direct, and Google Schoolar databases. Keywords used ((maternal obesity OR obesity in pregnancy) AND (macrosomia OR large for gestational)). There were 11 studies with a cohort design published in 2012-2022 that met the inclusion criteria. Analysis was performed using Revman 5.3. Results: There were 11 articles originating from three continents, namely Asia (2 studies from China, 2 from Saudi Arabia, 1 from Taiwan), the Americas (3 from the United States, 1 from Brazil), and the European continent (1 from Poland and 1 from Spanish). The heterogeneity of effect estimates between primary studies showed I² = 95% (p&lt;0.001), so the analysis used the Random Effect Model (REM). Obese pregnant women had a 2.03 times risk of having a baby with macrosomia compared to pregnant women without obesity (aOR=2.03, 95% CI=1.88 to 2.18; p&lt;0.001). Conclusion: Obesity in pregnant women increases the risk of having a baby with macrosomia. Keywords: maternal obesity, macrosomia.

Adolescent Obesity and Type Two Diabetes in Young Adults in the Minority Muslim Bedouin Population in Southern Israel.

Minority populations suffer from adolescent obesity at increasing rates and develop diabetes type 2 at a younger age. To assess the prevalence of adolescent obesity in the minority Bedouin population of Israel and its association with obesity and diabetes type 2 during young adulthood. A retrospective cohort study, based on computerized medical records. The study cohort was comprised of Bedouin adolescents, born in 1988-1990, who had BMI measurements at ages 14-19years in their medical records (N = 3310). The prevalence of obesity was 17.3% in middle adolescence, and 9.6% in late adolescence. The ORs for obesity in young adulthood were 30.1 (95% CI 19.1-49.3) and 40.9 (95% CI 25.7-69.1) for the middle and late adolescent groups, respectively. The incidence of diabetes type 2 per 105 person-years was 494.88 (95% CI 263.55-846.27) vs. 23.06 (95% CI 4.76-67.40) and 446.93 (95% CI 223.11-79 9.68) vs. 113.13 (95% CI 74.55-164.59) among adolescents with and without obesity in the middle and late adolescence groups, respectively. Interventions are needed to reduce the prevalence of adolescent obesity in the vulnerable Muslim Bedouin population in southern Israel.

System biology approaches identified novel biomarkers and their signaling pathways involved in renal cell carcinoma with different human diseases.

Renal cell carcinoma (RCC) is a type of cancer that develops in the renal epithelium of the kidney. It is responsible for approximately 3% of adult malignancies, and 90-95% of neoplasms originate from the kidney. Advances in tumor diagnosis, innovative immune therapeutics, and checkpoint inhibitors-based treatment options improved the survival rate of patients with RCC accompanied by different risk factors. RCC patients with diabetes, hepatitis C virus (HCV), or obesity (OB) may have a comorbidity, and finding the risk factor for better clinical treatment is an urgent issue. Therefore, the study focused on network-based gene expression analysis approaches to learning the impact of RCC on other comorbidities associated with the disease. The study found critical genetic factors and signal transduction pathways that share pathophysiology and commonly use dysregulated genes of the illness. Initially, the study identified 385 up-regulated genes and 338 down-regulated genes involved with RCC. OB, chronic kidney disease (CKD), type 2 diabetes (T2D), and HCV significantly shared 28, 14, 5, and 3 genes, respectively. RCC shared one down-regulated gene versican (VCAN) with OB and HCV and one down-regulated gene oxidase homolog 2 (LOXL2) with OB and CKD. Interestingly, most of the shared pathways were linked with metabolism. The study also identified six prospective biomarkers, signaling pathways, and numerous critical regulatory and associated drug candidates for the disease. We believe that the discovery will help explain these diseases' complicated interplay and aid in developing novel therapeutic targets and drug candidates.

Physiological Oxygen Levels Differentially Regulate Adipokine Production in Abdominal and Femoral Adipocytes from Individuals with Obesity Versus Normal Weight.

Adipose tissue (AT) inflammation may increase obesity-related cardiometabolic complications. Altered AT oxygen partial pressure (pO2) may impact the adipocyte inflammatory phenotype. Here, we investigated the effects of physiological pO2 levels on the inflammatory phenotype of abdominal (ABD) and femoral (FEM) adipocytes derived from postmenopausal women with normal weight (NW) or obesity (OB). Biopsies were collected from ABD and FEM subcutaneous AT in eighteen postmenopausal women (aged 50-65 years) with NW (BMI 18-25 kg/m2, n = 9) or OB (BMI 30-40 kg/m2, n = 9). We compared the effects of prolonged exposure to different physiological pO2 levels on adipokine expression and secretion in differentiated human multipotent adipose-derived stem cells. Low physiological pO2 (5% O2) significantly increased leptin gene expression/secretion in ABD and FEM adipocytes derived from individuals with NW and OB compared with high physiological pO2 (10% O2) and standard laboratory conditions (21% O2). Gene expression/secretion of IL-6, DPP-4, and MCP-1 was reduced in differentiated ABD and FEM adipocytes from individuals with OB but not NW following exposure to low compared with high physiological pO2 levels. Low physiological pO2 decreases gene expression and secretion of several proinflammatory factors in ABD and FEM adipocytes derived from individuals with OB but not NW.

Overlap of orthorexia, eating attitude and psychological distress in some Italian and Spanish university students.

Orthorexia nervosa (ON) is the persistent concern of maintaining the self-imposed diet to improve one's health. Many factors have been associated to ON in univ-ersity students. To assess the prevalence of ON in Italian and Spanish university students in relation to eating attitude and psychological distress, and the possible overlaps between ON (evaluated with different scored questionnaires from the originally proposed ORTO-15), distress and risk of eating disorders. This study was carried out on 160 students recruited at La Sapienza University of Rome and at the Catholic University of Murcia. Questionnaires were administered to evaluate ON (ORTO-15 and sub-scores), body concerns (Multidimensional Body-Self Relations Questionnaire, MBSRQ, and Body Uneasiness test, BUT), psychological distress (Kessler Psychological Distress Scale, K10), physical activity (International Physical Activity Questionnaire, IPAQ), eating attitude (Eating Attitudes Test, EAT-26) and malnutrition (Starvation Symptom Inventory, SSI). Sex differences, within the same country, and differences between Italian and Spanish students, within the same sex, were evaluated. The ORTO-15 positive subjects, assessed with the originally proposed cut-off, were above 70% in both Italian and Spanish students, with a higher prevalence in the Spanish sample (Italian females 76.3%, Italian males 70.7%; Spanish females 97.0%, Spanish males 96.3%). According to ORTO-7, about 30% of Italian and 48% of Spanish students were positive to ON with no significant sex differences. When excluding students underweight (UW), overweight (OW) or obese (OB), as well as those potentially at risk of eating disorders or presenting mild, moderate and severe distress, in the resultant normal weight (NW)-K10neg-EAT-26neg subgroup, we did not find many correlations observed in the whole sample, including those between ORTO scores and BUT, SSI, Total MBSRQ and some of its components. Moreover, ORTO-7 resulted in the only ON score unrelated with Body Mass Index, MBSRQ components and IPAQ-assessed intense activity, in the NW-K10neg-EAT-26neg subgroup. After this sort of "exclusion diagnosis", the prevalence of ON of these students on the overall sample resulted in 16.9%, 12.2%, 15.2% and 25.9% for Italian females, Italian males, Spanish females and Spanish males, respectively. In some university students ON could be a symptom of other conditions related to body image concerns and distress, as well as to high physical activity and appearance, fitness, health or illness orientation (from MBSRQ). However, ORTO-7 became independent from these confounding variables, after the exclusion of UW, OW, OB and students positive to EAT-26 and K10, suggesting the possibility of identifying orthorexic subjects with this specific questionnaire.

The Mediating Role of Dietary Inflammatory Index in the Association between Eating Breakfast and Obesity: A Cross-Sectional Study.

Obesity is closely related with diet, including the regularity of meals and inflammation in the diet. No previous study focused on the associations among eating breakfast, which is regarded the most important meal, dietary inflammation, and obesity. This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, with 23,758 participants involved. Obesity and dietary inflammation were measured by body mass index (BMI) and dietary inflammatory index (DII), respectively. Eating breakfast was defined by two days of dietary recalls based on NHANES dietary data. Pro-inflammatory diet and skipping breakfast were positively associated with obesity in the whole population. Compared with eating breakfast in both recalls, skipping breakfast had the higher OR of obesity, especially for individuals who reported no recall. Participants with diabetes were the sensitive population of these associations. Compared with participants who reported breakfast in both recalls, the mediated proportion of participants reported breakfast in one recall and in no recall were 24.71% and 27.34%, respectively. The association between eating breakfast and obesity was partly mediated by DII. We recommended eating breakfast regularly to reduce dietary inflammation, as well as further obesity, especially for diabetic populations.

Epidemiology of pre-pregnancy body mass index (BMI) among mothers in Abu Dhabi, the United Arab Emirates.

Pre-pregnancy obesity is a risk factor for several health problems such as gestational diabetes, preeclampsia, labor induction, postpartum hemorrhage, and neonatal hypoglycemia. Being underweight is a risk factor for fetal growth restriction. Despite the negative impact of abnormal pre-pregnancy body mass index (BMI) (over and underweight) on pregnancy outcomes, a limited amount of studies has been conducted on the prevalence of pre-pregnancy over and underweight and associated factors in the United Arab Emirates (UAE). Thus, the aim of this study was to investigate the prevalence and factors associated with underweight, overweight, and obesity among mothers with children under the age of 2 years in Abu Dhabi, the UAE. A cross-sectional multicenter study was conducted in 2017 and included data from seven government health care centers in Abu Dhabi. Maternal pre-pregnancy BMI was calculated as the weight in kilograms (kg) divided by the square of the height in meters (m), (kg/m2). A total of 1,622 mother–child pairs were included in this study. Out of the 1,622 mothers, 43 (2.7%) were underweight, 1,068 (65.8%) were normal weight, 412 (25.4%) were overweight, and 99 (6.1%) were obese. Mothers with advanced maternal age (AMA) (≥35 years) were more likely to be overweight, odds ratio [OR] = 1.93, (95% confidence interval [CI] 1.52–2.3), p ≤ 0.001, and obese OR = 2.15 (95% CI 1.32–3.39), p = 0.001. Mothers with lower family income were more likely to be obese OR = 2.72 (95% CI 1.44–5.93), p = 0.002. Mothers with high parity (≥2) were more likely to be overweight OR = 1.91 (95% CI 1.49–2.50), p ≤ 0.001; obese OR = 1.76 (95% CI 1.06–2.92), p = 0.024; and less likely to be underweight OR = 0.52 (95% CI 0.27–0.94), p = 0.037. Obese mothers were more likely to deliver via cesarean section (CS) OR = 1.95 (95% CI 1.27–2.96), p = 0.002. This study provides valuable baseline information on the epidemiology of pre-pregnancy BMI in the UAE. The sociodemographic factors identified in the study can be used to target at-risk women. The study findings can also be used to develop contextualized strategies to prevent and manage complications associated with abnormal pre-pregnancy BMI in Emirati women.

Preventive Effects of Moringa oleifera on Obesity and Hyperlipidaemia: A Systematic Review

Obesity and hyperlipidaemia are metabolic dysregulations, arising from poor lifestyle and excessive dietary intakes which may contribute to many chronic diseases if not treated. Studies have shown that plant-based supplementations can suppress this metabolic dysregulation. Moringa oleifera (MO) is a plant that is known to be nutritious and can alleviate obesity and hyperlipidaemia owing to its medicinal properties. A literature search on the effects of MO on obesity and hyperlipidaemia using electronic databases which included Ovid Medline and Scopus was performed. Specific descriptors were used to perform the search strategy. The articles were selected based on the principles that report on the effects of MO on obesity and hyperlipidaemia. Titles of the articles were screened for Moringa oleifera OR obesity OR hyperlipidaemia. Twenty-nine articles, 19 from Ovid Medline and 10 from Scopus were selected based on the inclusion and exclusion criteria. A flow chart was created to represent the study selection. Based on the chosen articles, MO was shown to suppress obesity and hyperlipidaemia directly and indirectly through the regulation of gene expression, enzyme activity and adipocytokines. Through animal trials, MO demonstrated promising results in alleviating obesity and hyperlipidaemia. More human trials should be performed to strengthen the accomplished effects seen on animals. As there were no side effects identified in animal studies, it could be recommended to patients with obesity and hyperlipidaemia.

Correlations between Obesity, Polycystic Ovary Syndrome, and Sleep Apnea: A Meta-Analysis

Background: Obesity is one of the biggest public health problems in the world. Obesity is associated with various health problems, decreased quality of life and death. Obesity is known to have an impact on women's lives, namely Polycystic Ovary Syndrome (PCOS) which if not treated immediately can cause sleep apnea. This study aims to analyze the relationship between obesity and PCOS and sleep apnea. Subjects and Method: This research is a systematic review and meta-analysis. Population = women, Intervention = obesity, Comparison = not obese, Outcomes = PCOS and sleep apnea. Article searches through journal databases include: PubMed, Science Direct, Google Scholar, and Springerlink. The keywords used are obesity OR obese AND PCOS OR “Polycystic Ovary Syn- drome” AND “sleep apnea” OR “Poor Sleep” OR “obstructive sleep apnea”. Articles were selected with the help of PRISMA flow diagrams. Inclusion criteria include full-text articles with obser- vational studies, multivariate analysis results in the form of aOR values and published from 2012- 2021. Eligible articles were analyzed using the Revman 5.3 application. Results: Eighteen articles from the United States, Brazil, China, Turkey, Iraq, Pakistan, Sri Lanka, Korea, West Africa, East Africa, Nigeria and the United Kingdom were included in the meta- analysis. A meta-analysis of the results of the case-control study design subgroup (4 articles) and the cross-sectional study (4 articles) showed that obese women had a 1.14-fold increased risk of developing PCOS compared to non-obese women (aOR = 1.14; 95% CI = 1.03 to 1.26; p= 0.010). A meta-analysis of 10 cross-sectional studies showed that obese women increased the risk of developing sleep apnea 4.66 times than non-obese women (aOR = 4.66; 95% CI = 3.23 to 6.71; p = &lt;0.001). Conclusion: Obesity is a risk factor for PCOS (Polycystic Ovary Syndrome) and sleep apnea in women. Keywords: obesity, PCOS, sleep apnea, meta-analysis. Correspondence: Saktryana Endang Ragil Jayanti. Master’s Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: Saktryana.agil@gmail.com. Mobile: 082242154117.

Associations Between Weight and Lower Respiratory Tract Disease Outcomes in Hospitalized Children.

To identify associations between weight status and clinical outcomes in children with lower respiratory tract infection (LRTI) or asthma requiring hospitalization. We performed a retrospective cohort study of 2 to 17 year old children hospitalized for LRTI and/or asthma from 2009 to 2019 using electronic health record data from the PEDSnet clinical research network. Children <2 years, those with medical complexity, and those without a calculable BMI were excluded. Children were classified as having underweight, normal weight, overweight, or class 1, 2, or 3 obesity based on Body Mass Index percentile for age and sex. Primary outcomes were need for positive pressure respiratory support and ICU admission. Subgroup analyses were performed for children with a primary diagnosis of asthma. Outcomes were modeled with mixed-effects multivariable logistic regression incorporating age, sex, and payer as fixed effects. We identified 65 132 hospitalizations; 6.7% with underweight, 57.8% normal weight, 14.6% overweight, 13.2% class 1 obesity, 5.0% class 2 obesity, and 2.8% class 3 obesity. Overweight and obesity were associated with positive pressure respiratory support (class 3 obesity versus normal weight odds ratio [OR] 1.62 [1.38-1.89]) and ICU admission (class 3 obesity versus normal weight OR 1.26 [1.12-1.42]), with significant associations for all categories of overweight and obesity. Underweight was also associated with positive pressure respiratory support (OR 1.39 [1.24-1.56]) and ICU admission (1.40 [1.30-1.52]). Both underweight and overweight or obesity are associated with increased severity of LRTI or asthma in hospitalized children.